The US Supreme Court has agreed to review a lawsuit that could decide the future of individual state bans on medicalised child gender transitions after half the nation’s 50 states passed legislation outlawing the practice. It will hear an appeal challenging a Tennessee law banning gender affirming medical treatment for children under 18. It will be the first time the current nine Supreme Court justices have an opportunity to weigh in on the issue.
Just last week, the Texas Supreme Court upheld the state’s ban on gender affirming care for transgender minors, rejecting pleas from parents that it violates their right to decide on and seek medical care for their children. The Texas law prevents transgender children from accessing hormone therapies, puberty blockers and transition surgeries. Last month, South Carolina became the 25th state to adopt a law restricting or banning gender affirming medical care for transgender minors.
The US Supreme Court will have to decide whether American states have the legal right to ban gender affirming treatments for children. Last year, a Court of Appeals allowed a Tennessee law enacting the ban, to take effect. The nation’s highest court will hear the appeal against that ruling.
Three Tennessee transgender teenagers, their parents, and a doctor who provides transgender medications argued the 2023 Tennessee ban violates a US constitutional guarantee of equal protection under the law by discriminating on the basis of sex. The Biden administration along with a number of major US medical groups, has joined the plaintiffs’ side in this case, with the Justice Department to argue that the treatment is ‘life-saving care.’
The plaintiffs claim the law prohibits transgender individuals from accessing drugs and therapies that are available to other adolescents with medical needs. They also argue that the ban is a violation of a parental right to access necessary care for their children.
US Solicitor General Elizabeth Prelogar told the Supreme Court justices in a brief filed last year that the Tennessee law and those like it “inflict profound harm on transgender adolescents and their families” by denying “appropriate and necessary” treatment for a serious medical condition. She argued that there is uncertainty around the legality of transgender medical bans and that the Supreme Court should step in to settle the dispute. Tennessee’s Attorney-General Jonathan Skrmetti agreed, saying the nation’s highest court will bring much needed clarity on whether the US Constitution contains special protections for gender identity.
Tennessee’s lawyers say the state’s transgender law is a reflection of the will of the state’s elected lawmakers and addresses a pressing public concern. “Tennessee, like many other states, acted to ensure that minors do not receive these treatments until they can fully understand the lifelong consequences, or until the science is developed to the point that Tennessee might take a different view of their efficacy,” the state wrote in a brief filed with the Supreme Court.
Earlier this year, the Supreme Court upheld an Idaho ban against transgender medical treatments involving children, although they did not express an opinion on the constitutionality of the statute. The court is likely to hear arguments in the Tennessee case later this year, with its decision not expected until the middle of next year.
Tennessee’s case will also reference multiple European reviews and studies that children risk serious physical and psychological harm if they undergo medical treatment for gender dysphoria. Children are no longer routinely prescribed puberty blockers at gender clinics in the UK after a comprehensive review of medical gender transitions for children found there was not enough evidence that they are safe or effective. The independent review found that previous studies on the subject are of “poor quality” and there is “very limited evidence on the longer-term outcomes” associated with medicalised transition.
“This is an area of remarkably weak evidence, and yet results of studies are exaggerated or misrepresented by people on all sides of the debate to support their viewpoint,” Hilary Cass, who led the review, wrote in the introduction. “The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.”
The American College of Pediatricians has listed possible side effects of puberty blockers as “osteoporosis, mood disorders, seizures, cognitive impairment and, when combined with cross-sex hormones, sterility” while warning that cross-sex hormones can cause youth to experience “an increased risk of heart attacks, stroke, diabetes, blood clots and cancers across their lifespan.”
A nine-year-long study from Germany has found that two-thirds of young people who identify as transgender, will grow out of it within five years. A team of Dutch researchers came to a nearly identical conclusion. After reviewing the records of 2,772 adolescents aged 11-24 in the Netherlands, they found a desistance rate of 64%. Young people were nearly 10-times more likely to feel better about their birth sex than worse during that time frame, the study reported.
Many European countries have either halted or scaled back medical gender transitions for children, following these revelations.
